Tang Jinglong, Wang Shuo, Liu Li, Wang Jian, Wang Chunren
Center for Medical Devices Testing, National Institutes for Food and Drug Control, Beijing 100050, China.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2013 Feb;30(1):166-9.
The aim of this study was to investigate the pulsatile-flow performance in vitro of a new heart valve prostheses implanted with minimally invasive techniques (HVPMIT). Three HVPMITs were tested valves and another three original biological heart valve prostheses acted as reference valves. The pulsatile-flow parameters (including mean pressure drop, regurgitant percentage of stroke volume, and effective orifice area) were tested in a pulse duplicator according to the methods listed in ISO5840-2005 and GB 12279-2008. The results demonstrated that the regurgitant percentage of stroke volume of tested valves was up to 13%. It was significantly higher than that of the reference valves. This result suggested that paravalvular leakage had occurred in the tested valves. It was found in the further analysis that because HVPMIT was not sewn into the heart tissue when the HVPMIT was implanted in vivo and there was not a sewing ring in the HVPMIT, when tested valves were fixed in the pulse duplicator, some gaps might exist between the stent of HVPMIT and the fix gasket, and the paravalvular leakage could therefore take place through these gaps. This study demonstrated that there are significant differences in the shape, structure, fixation in vivo and clinical operational methods between HVPMIT and original biological heart valve prostheses. It is necessary to establish new test methods which adapt for HVPMIT to evaluate its pulsatile-flow performance according to its own features.
本研究旨在探讨采用微创技术植入的新型心脏瓣膜假体(HVPMIT)的体外脉动流性能。对三个HVPMIT进行了测试,另外三个原始生物心脏瓣膜假体作为对照瓣膜。根据ISO5840 - 2005和GB 12279 - 2008中列出的方法,在脉动复制器中测试脉动流参数(包括平均压力降、每搏量反流百分比和有效瓣口面积)。结果表明,测试瓣膜的每搏量反流百分比高达13%。显著高于对照瓣膜。该结果表明测试瓣膜发生了瓣周漏。进一步分析发现,由于HVPMIT在体内植入时未缝合到心脏组织中且HVPMIT中没有缝合环,当测试瓣膜固定在脉动复制器中时,HVPMIT的支架与固定垫圈之间可能存在一些间隙,因此瓣周漏可能通过这些间隙发生。本研究表明,HVPMIT与原始生物心脏瓣膜假体在形状、结构、体内固定和临床操作方法上存在显著差异。有必要建立适合HVPMIT的新测试方法,以根据其自身特点评估其脉动流性能。